Individual
MRS. PHYLLIS G SIMON-GOLDMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
270 UNION AVE, HOLBROOK, NY 11741
(631) 331-6200
(631) 331-6282
Mailing address
270 UNION AVE, FREED, KLEINBERG, NUSSBAUM & FEST, KRONBERG, M.D., LLP, HOLBROOK, NY 11741
(631) 588-4442
(631) 471-3039
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
240746-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03080866
—
NY
Enumeration date
05/28/2007
Last updated
04/12/2012
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